Hospitalization

From Anvita Health Wiki

Contents 1 Complications 2 Notes 3 Additional Terms 4 References

Complications

• hospital-acquired infection
• loss of ability to perform basic activities of daily living ( bADLs) during hospitalization portends substantial 1-year morbidity & mortality in older patients (see functional status in hospitalized elderly)
• risk factors for in hospital functional decline & nursing home placement

• advanced age
• dependence in iADLs
• delirium
• cognitive impairment

• risk factors for rehospitalization ( inpatients):

• advanced age
• multiple comorbid conditions
• cognitive impairment
• depression
• living alone
• recent hospitalization
• impaired physical function

• nursing ( RN) staffing below target levels & high patient burden associated with increased in-hospital mortality [2]

Notes

• in hospital stratgies that reduce mortality (example = MI)

• monthly meetings to review myocardial infarction cases with hospital clinicians & staff who transport patients to the hospital
• having an on-site cardiologist at all times
• cultivating an environment in which clinicians are encouraged to solve problems creatively
• avoiding cross-training of intensive care unit nurses for cardiac catheterization laboratories
• having at least one quality-improvement champion who is a physician rather than a nurse

• in hospital coordinated discharge planning with follow-up at home reduces subsequent hospitalization
• the KELS evaluates needs of patient in the community after hospital discharge

Additional Terms

• functional status in hospitalized elderly
• hospital
• justification for hospitalization
• Kohlman Evaluation of Living Skills (KELS)
• length of stay (LOS)

References

1. Geriatrics Review Syllabus, American Geriatrics Society, 5th edition, 2002-2004; 7th edition
2. Needleman J et al. Nurse staffing and inpatient hospital mortality. N Engl J Med 2011 Mar 17; 364:1037 PMID: [1]
3. Bradley EH et al. Hospital strategies for reducing risk-standardized mortality rates in acute myocardial infarction. Ann Intern Med 2012 May 1; 156:618. PMID: [2]

hospitalization